Evaluation of Beta-Tri Calcium Phosphate as Bone Substitute Materials for Ridge Preservation after Extraction Procedure (Comparative Study)
Background: Bucco-lingual alveolar ridge collapse and significant ridge atrophy because of physiologic bone remodeling may continue up to 12 months’ post-extraction.
Bone substitute with suitable graft material and barrier membrane immediately after tooth extraction is most predictable way in ridge preservation. A synthetic graft, pure phase β-tricalcium phosphate, has been documented in human and animal studies to be resorbed and replaced by vital bone after 4 months with CBCT examination, in addition to resorbable collagen membrane for better stabilization.
In addition to preserve the ridge volume the clinical observations revealed excellent soft tissue healing without loss of attached gingiva.
Aims of the study: 1-To evaluate the effect of bio absorbable bone graft Material (B-tri calcium phosphate) with a collagen membrane to preserve the alveolar ridge dimensions following tooth extraction and to compare the results with unassisted alveolar sockets. 2-To evaluate the effect of the B-TCP on the bone density of post extraction–sockets by CBCT and to compare the density of cancellous bone formed between study and control groups.
Materials and Methods: This prospective clinical study took place at Department of Oral and Maxillofacial Surgery, College of Dentistry, Included 21 Patients 8 Male and 13 females with 38 extracted teeth. Age range of 22-60 years with a mean age (42.86 ± 10.57) participants were divided into two groups, , study group in which the B-TCP bone graft material was placed inside a fresh extraction socket and control group conducted without bone grafting. The patients' age, sex, number of teeth, oral hygiene state was recorded. CBCT X-Ray image were taken before extraction, both groups had simple non-traumatic teeth extraction, then with study group preparation of about 0.5 mg of B –TCP according to socket size, mix it with normal saline and gently adapt into the socket with condensation, cover with a resorbable collagen membrane and suturing for better stabilization. The suture was removed at 8 -10 days. After 4 months’ new bone formed in the socket measured by CBCT. Data description, analysis and presentation were performed using Statistical Package for social Science (SPSS version 21, Chicago, IL, USA) Statistical analyses.
Results: Of the 38 extracted teeth ,20 grafted teeth with bone graft and 18 was free from graft. There was a significant increase in bone density through 4 months Post-operatively in study group (1372.325 ± 133.216) compare with control group (505.907 ± 377.185). Alveolar socket height loss was reducing post -operatively in study group than control group (7.935 ± 2.194 versus7.372 ± 1.753) respectively, but with not statically difference between two groups. Regarding width loss, there were a significant difference in reduce width loss post operatively in study than control (5.082 ± 1.324 versus 3.981 ± 0.979).
Conclusion: In this study, the Quantity of bone formation in the form of linear measurement of Bone width and height exhibited noticeable preservation of the extraction socket and reduction of the degree of alveolar bone loss in ßTCPCol group. when the ridge dimensions at 4 months compared with those at base line with favorable results to ßTCP-Col study group over control group after complete healing of the extraction socket B-TCP show promising effect on accelerating the bone density of post –extraction sockets after 4 months.